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Efficient Early Diagnosis of Sepsis Using Whole-Blood PCR–Reverse Blot Hybridization Assay Depending on Serum Procalcitonin Levels

Sepsis is one of the medical emergencies, and its early detection, within the first hours of development, and proper management improve outcomes. Molecular diagnostic assays using whole blood collected from patients with suspected sepsis have been developed, but the decision making is difficult beca...

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Autores principales: Kim, Seoyong, Kim, Jungho, Kim, Hyo Youl, Uh, Young, Lee, Hyeyoung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7411407/
https://www.ncbi.nlm.nih.gov/pubmed/32850901
http://dx.doi.org/10.3389/fmed.2020.00390
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author Kim, Seoyong
Kim, Jungho
Kim, Hyo Youl
Uh, Young
Lee, Hyeyoung
author_facet Kim, Seoyong
Kim, Jungho
Kim, Hyo Youl
Uh, Young
Lee, Hyeyoung
author_sort Kim, Seoyong
collection PubMed
description Sepsis is one of the medical emergencies, and its early detection, within the first hours of development, and proper management improve outcomes. Molecular diagnostic assays using whole blood collected from patients with suspected sepsis have been developed, but the decision making is difficult because of the possibility of false positives, due to contamination. Here, we evaluated the performance of the reverse blot hybridization assay (REBA) Sepsis-ID test for the detection of sepsis-causing microorganisms using whole-blood samples. In addition, the concentrations of C-reactive protein (CRP) and procalcitonin (PCT) were determined to evaluate whether these biomarkers can provide criteria for performing REBA Sepsis-ID in clinical settings. For this study, EDTA-anticoagulated whole blood was simultaneously collected for REBA Sepsis-ID and blood culture from 440 patients with suspected sepsis, from January to October 2015. In addition, CRP and PCT concentrations were measured in 227 patients. The overall positive rates of REBA Sepsis-ID and blood culture were 16.6% (73/440) and 13.9% (61/440), respectively. The pathogen-positive rates of REBA Sepsis-ID and blood culture were 9.8% (43/440) and 9.5% (42/440), respectively. The areas under the receiver operating characteristic (AUROC) curves of PCT and CRP for predicting pathogen-positive results of REBA Sepsis-ID were 0.72 and 0.69, respectively. The PCT concentrations in the group of patients aged ≥50 years were significantly higher than those in the group aged <50 years. After adjusting for age, the PCT AUROC value was 0.77 for predicting pathogen-positive results of REBA Sepsis-ID. The optimal cutoff values of PCT concentrations for subsequent application of REBA Sepsis-ID were 0.12 ng/mL in all patients and 0.22 ng/mL in patients aged ≥50 years. Our observations showed that REBA Sepsis-ID using whole blood was advantageous for the early detection of sepsis-causing microorganisms, and the PCT concentration could be used to determine the necessity of using REBA Sepsis-ID in clinical settings. The application of REBA Sepsis-ID using whole blood, based on the PCT concentration, may contribute to a highly efficient detection of sepsis-causing microorganisms.
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spelling pubmed-74114072020-08-25 Efficient Early Diagnosis of Sepsis Using Whole-Blood PCR–Reverse Blot Hybridization Assay Depending on Serum Procalcitonin Levels Kim, Seoyong Kim, Jungho Kim, Hyo Youl Uh, Young Lee, Hyeyoung Front Med (Lausanne) Medicine Sepsis is one of the medical emergencies, and its early detection, within the first hours of development, and proper management improve outcomes. Molecular diagnostic assays using whole blood collected from patients with suspected sepsis have been developed, but the decision making is difficult because of the possibility of false positives, due to contamination. Here, we evaluated the performance of the reverse blot hybridization assay (REBA) Sepsis-ID test for the detection of sepsis-causing microorganisms using whole-blood samples. In addition, the concentrations of C-reactive protein (CRP) and procalcitonin (PCT) were determined to evaluate whether these biomarkers can provide criteria for performing REBA Sepsis-ID in clinical settings. For this study, EDTA-anticoagulated whole blood was simultaneously collected for REBA Sepsis-ID and blood culture from 440 patients with suspected sepsis, from January to October 2015. In addition, CRP and PCT concentrations were measured in 227 patients. The overall positive rates of REBA Sepsis-ID and blood culture were 16.6% (73/440) and 13.9% (61/440), respectively. The pathogen-positive rates of REBA Sepsis-ID and blood culture were 9.8% (43/440) and 9.5% (42/440), respectively. The areas under the receiver operating characteristic (AUROC) curves of PCT and CRP for predicting pathogen-positive results of REBA Sepsis-ID were 0.72 and 0.69, respectively. The PCT concentrations in the group of patients aged ≥50 years were significantly higher than those in the group aged <50 years. After adjusting for age, the PCT AUROC value was 0.77 for predicting pathogen-positive results of REBA Sepsis-ID. The optimal cutoff values of PCT concentrations for subsequent application of REBA Sepsis-ID were 0.12 ng/mL in all patients and 0.22 ng/mL in patients aged ≥50 years. Our observations showed that REBA Sepsis-ID using whole blood was advantageous for the early detection of sepsis-causing microorganisms, and the PCT concentration could be used to determine the necessity of using REBA Sepsis-ID in clinical settings. The application of REBA Sepsis-ID using whole blood, based on the PCT concentration, may contribute to a highly efficient detection of sepsis-causing microorganisms. Frontiers Media S.A. 2020-07-31 /pmc/articles/PMC7411407/ /pubmed/32850901 http://dx.doi.org/10.3389/fmed.2020.00390 Text en Copyright © 2020 Kim, Kim, Kim, Uh and Lee. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Kim, Seoyong
Kim, Jungho
Kim, Hyo Youl
Uh, Young
Lee, Hyeyoung
Efficient Early Diagnosis of Sepsis Using Whole-Blood PCR–Reverse Blot Hybridization Assay Depending on Serum Procalcitonin Levels
title Efficient Early Diagnosis of Sepsis Using Whole-Blood PCR–Reverse Blot Hybridization Assay Depending on Serum Procalcitonin Levels
title_full Efficient Early Diagnosis of Sepsis Using Whole-Blood PCR–Reverse Blot Hybridization Assay Depending on Serum Procalcitonin Levels
title_fullStr Efficient Early Diagnosis of Sepsis Using Whole-Blood PCR–Reverse Blot Hybridization Assay Depending on Serum Procalcitonin Levels
title_full_unstemmed Efficient Early Diagnosis of Sepsis Using Whole-Blood PCR–Reverse Blot Hybridization Assay Depending on Serum Procalcitonin Levels
title_short Efficient Early Diagnosis of Sepsis Using Whole-Blood PCR–Reverse Blot Hybridization Assay Depending on Serum Procalcitonin Levels
title_sort efficient early diagnosis of sepsis using whole-blood pcr–reverse blot hybridization assay depending on serum procalcitonin levels
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7411407/
https://www.ncbi.nlm.nih.gov/pubmed/32850901
http://dx.doi.org/10.3389/fmed.2020.00390
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